Browsing by Author "Smith, Emily Marie"
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Item Open Access Using High Resolution Peripheral Quantitative Computed Tomography to Evaluate Bone Health and Relative Energy Deficiency in Sport Risk in Elite Winter Sport Athletes(2024-08-27) Smith, Emily Marie; Boyd, Steven; Burt, Lauren; Roach, Koren; Gabel, Leigh; Kenny, SarahRelative Energy Deficiency in Sport (REDs) is a syndrome resulting from problematic low energy availability (LEA). Low areal bone mineral density (aBMD) is a primary indicator of LEA and is measured at the hip or spine by dual X-ray absorptiometry (DXA). High-resolution peripheral quantitative computed tomography (HR-pQCT) measures volumetric BMD (vBMD), microarchitecture, geometry, and estimated strength reported as failure load. The objective of this study was to assess the differences in bone parameters using HR-pQCT in elite winter sport athletes identified as at-risk or not at-risk of REDs using the Clinical Assessment Tool (CAT2). Participants included 101 athletes (24.14.4 SD years; 53% female). HR-pQCT scans of the non-dominant radius and left tibia were analyzed and compared to DXA results. Seventeen athletes (17%; 71% female) were at-risk of REDs based on the CAT2. Bland-Altman plots suggested that compared to aBMD, Z-scores were more like failure load (ICC=0.420.10) than vBMD (ICC=0.250.07). After covarying for lean mass, odds ratios (OR) suggested increased likelihood of REDs risk classification for those with low cortical thickness (radius: OR=2.14, p=0.021; tibia: OR=1.89, p=0.037), and area (radius: OR=3.04, p=0.007; tibia: OR=2.74, p=0.006), total vBMD (tibia: OR=2.06, p=0.030), and failure load (tibia: OR=2.17, p=0.033). ROC-AUC analysis showed very poor to poor (0.50